Obamacare growth spurt: 10.1M extra on Medicaid

Obamacare's "other" big program is more than keeping pace with its better-known sibling.

The Medicaid and CHIP health-care programs that cover the poor and children now have 10.1 million extra people covered since the period just before Obamacare insurance marketplaces launched in the fall of 2013, federal officials said Monday.

The most significant enrollment increases came in states that have loosened eligibility requirements for Medicaid, as allowed by the Affordable Care Act. Medicaid expansion to cover nearly all poor adults is a key pillar of the ACA, along with the creation of government-run exchanges selling private Obamacare insurance plans.

Officials said 444,324 people were added in November 2014 to the Medicaid/Children's Health Insurance Program rolls.

As of November, there was a total of 68.97 million people on Medicaid and CHIP, which are jointly funded by the federal government and individual states.

Luke Sharrett | The Washington Post | Getty Images

Despite suffering from a past heart attack and diabetes, Kentucky resident Mary Blair was able to receive medical coverage through Medicaid expansion under the Affordable Care Act.

In the 26 states and the District of Columbia that had expanded Medicaid eligibility as of November, there was a nearly 25.5 percent increase in the number of people covered by Medicaid or CHIP since the summer of 2013, officials said.

In the remaining nonexpansion states, enrollment in those programs grew by only about 7 percent over the same period, according to Centers for Medicare and Medicaid Services.

Since then, two other states, Pennsylvania and Indiana, have adopted Medicaid expansion. Indiana's expansion program, which could cover up to 350,000 extra people, was approved just last week, and is starting to enroll people this month. Pennsylvania's program started sign-ups in January, and could end up covering as many as 600,000 newly eligible people.

Medicaid's added enrollment tally compares favorably with sign-ups in private insurance plans sold on government-run Obamacare exchanges. So far this open enrollment season, about 9.5 million people have selected plans that take effect in 2015 from those exchanges.

Unlike Obamacare plans, Medicaid has open enrollment year-round.

While some of the new Medicaid beneficiaries in expansion states are newly eligible, the ACA has been credited with boosting enrollment by previously eligible people in Medicaid.

The law requires nearly all Americans to have had some form of health coverage as of 2014 or pay a fine, and there was significant publicity about the government-run Obamacare private insurance exchanges from 2013 into 2014.

The ACA as originally written essentially mandated that every state expand its Medicaid programs to cover nearly all poor adults. Before then, there was variance in how states covered poor people, with different income levels, and some poor adults excluded entirely in some cases.

The health-care law provided that the federal government would cover 100 percent of the costs for the newly eligible through 2016, and that its share would gradually decrease to no less than 90 percent thereafter. Traditional Medicaid's coverage costs are split more or less evenly between the federal governments and the states.

But a 2012 Supreme Court decision said it was up to each state to decide whether to expand its Medicaid programs.

While Democratic-led states largely approved expansion, there was much more reluctance to do so among Republican-led states, whose elected officials tended to oppose Obamacare. But an increasing number of Republican governors have adopted or are considering expansion because of pressure by hospitals, business interests and health-care advocates.